Scottish hospices want clarity after funding row

Pensions dispute left hospices shouldering increased costs

Thursday 4th July 2019

Hospices in Scotland are calling for clarity after a funding row between the Scottish and UK governments led to hospices picking up higher pension bills that left them “out of pocket”, healthandcare.scot can disclose.

Now sector leaders are voicing concerns organisations delivering palliative and end-of-life care might not see the full share of promised additional funding, and warn further delays could heap more pressure on an already struggling sector.

Scottish hospices have been paying an additional £76k every month since April when the UK Government refused to pass on enough cash to cover increased NHS pensions employer contributions brought in by the Treasury.

The Scottish Government says NHS boards are finalising the arrangements to pass on extra funding to hospices. Hospice UK says its vital its members get the money they were promised “without further delay”.

Ministers pledged to cover the bill but did not say when the cash would be provided, leaving hospices shouldering the costs themselves in the interim.

One figure healthandcare.scot spoke to said the sector had been left “in limbo” during this period, even as hospices in England were exempted from paying the additional burden.

Another said: “For smaller hospices, this is obviously quite a significant increase in their outgoings for a couple of months.

Although obviously they’ll get the funding back, it’s not particularly ideal, if you’re in a small hospice and you’re looking at the books month-to-month rather than from the year-to-year, to then find out you have to pay a few thousand a month more until the government sees fit to give you the funding.”

Last month the Health Secretary wrote to NHS boards saying the Scottish Government was taking the ‘unprecedented’ step of shifting money from elsewhere in its budget so it could meet the £48m NHS pensions gap.

Even after Ms Freeman instructed NHS bodies to pass on a ‘relevant share’ of this money to hospices, there are concerns they could still not receive the full amount.

Kate Lennon, chief executive of St Vincent’s Hospice in Johnstone, Renfrewshire, and chair of a leadership group for Scottish hospices, tells healthandcare.scot: “It is our understanding that some health and social care partnerships (HSCPs) are still working through the detail of the pension payments.

“Although the Cabinet Secretary [Jeane Freeman] states in her letter of 19th June to NHS chief cxecutives ‘where you engage with Direction Bodies for provision of services, please can you ensure that you pass on the relevant share of funding for employer pension costs,’ it would appear that there will be no guarantees that health boards will treat all hospices in the same way.

Hospice UK represents 16 adult and children’s hospices in Scotland.

Helen Malo, Hospice UK’s policy and advocacy manager for Scotland, says: “It is welcome news that the Scottish Government will allocate funding to NHS boards to cover the increase in employer contributions to NHS pensions faced by charitable hospices.

“However, it is vital that the relevant share of this funding is passed on to hospices as soon as possible without further delay and that it fully meets the increased costs they face.

“Hospices have been out of pocket for several months since the increase in pension employer contributions was introduced, at a time when many are already struggling financially.

“The Scottish Government has made it very clear that this funding should be passed on to hospices. Health boards and HSCPs now need to act swiftly to put this into practice. We hope that NHS boards and integration authorities will consider the needs of people with life-limiting conditions and their families in their areas when allocating this funding”.

The Scottish Government tells healthandcare.scot that Scottish Ministers are facing a £100m future funding shortfall, on top of the pensions shortfall, after Whitehall failed to pass on £55m in health funding.

A spokesperson says: “We continue to prioritise and protect frontline health services in Scotland and are providing additional funding to meet the increased pension costs for the NHS in Scotland, including hospices that are members of the NHS pension scheme.

“Funding will be passed to hospices by NHS Boards. NHS Boards are finalising the necessary arrangements to provide funding in the usual way and are in contact with hospices to provide further detail.”